血清IL-12与hs-CRP对新生儿感染性疾病的诊断效果研究
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摘要
目的探索血清白细胞介素-12(Interleukin-12,IL-12)与超敏C-反应蛋白(High-sensitivity C-reactive protein,hs-CRP)对新生儿感染性疾病的诊断效果。方法选择从2015年10月-2017年12月医院收治的新生儿感染病例108例,根据新生儿感染性疾病诊断标准分为重症组52例,轻症组56例,另选择50名健康新生儿作为对照组,检测所有新生儿血清IL-12和hs-CRP。结果重症组患儿血清IL-12及hs-CRP高于轻症组和对照组,轻症组患儿血清IL-12及hs-CRP高于对照组(P<0.05);重症组和轻症组中细菌感染患儿血清IL-12及hs-CRP高于非细菌感染患儿(P<0.05);以IL-12≥300ng/L为标准判断患儿发生败血症或感染性休克的敏感性为66.67%,特异性为83.87%;以hs-CRP≥20mg/L为标准判断的敏感性为71.43%,特异性为80.65%;两者联合判断敏感性为85.71%,特异性为93.55%。结论血清IL-12与hs-CRP能够用来早期诊断新生儿感染性疾病,判断是否细菌感染,并能较准确的判断患儿是否发生败血症及感染性休克。
OBJECTIVE To explore the diagnostic effect of serum interleukin-12(IL-12)and high-sensitivity C-reactive protein(hs-CRP)on neonatal infectious diseases.METHODS 108 cases of neonatal infection treated in our hospital from Oct.2015 to Dec.2017 were selected,and divided into 52 cases of severe infection and 56 cases of mild infection according to the diagnostic criteria for neonatal infectious diseases.Another 50 healthy newborns were selected as the control group.The levels of serum IL-12 and hs-CRP were detected in all newborns.RESULTS The levels of serum IL-12 and hs-CRP in the severe diseases group were significantly higher than those in the mild diseases group and the control group,the levels of serum IL-12 and hs-CRP in the mild diseases group were significantly higher than those in the control group(P<0.05).In the severe disease group and mild diseases group,the levels of serum IL-12 and hs-CRP of children with bacterial infection were significantly higher than those of children with non-bacterial infection(P<0.05).When IL-12≥300 ng/L was used as the positive criterion,the sensitivity and specificity in diagnosing sepsis or septic shock were 66.67%and 83.87%.When hs-CRP≥20 mg/L was used as the positive criterion,the sensitivity and specificity in diagnosing sepsis or septic shock were71.43%and 80.65%.When using IL-12≥300 ng/L and hs-CRP≥20 mg/L as the combinatorial positive criteria,the sensitivity and specificity in diagnosing sepsis or septic shock were 85.71%and 93.55%.CONCLUSIONSerum IL-12 and hs-CRP levels can be used for early diagnosis of neonatal infectious diseases and determination of occurrence of bacterial infection,and they can be used to accurately determine whether sepsis and septic shock would occur in the children.
OBJECTIVE To explore the diagnostic effect of serum interleukin-12(IL-12)and high-sensitivity C-reactive protein(hs-CRP)on neonatal infectious diseases.METHODS 108 cases of neonatal infection treated in our hospital from Oct.2015 to Dec.2017 were selected,and divided into 52 cases of severe infection and 56 cases of mild infection according to the diagnostic criteria for neonatal infectious diseases.Another 50 healthy newborns were selected as the control group.The levels of serum IL-12 and hs-CRP were detected in all newborns.RESULTS The levels of serum IL-12 and hs-CRP in the severe diseases group were significantly higher than those in the mild diseases group and the control group,the levels of serum IL-12 and hs-CRP in the mild diseases group were significantly higher than those in the control group(P<0.05).In the severe disease group and mild diseases group,the levels of serum IL-12 and hs-CRP of children with bacterial infection were significantly higher than those of children with non-bacterial infection(P<0.05).When IL-12≥300 ng/L was used as the positive criterion,the sensitivity and specificity in diagnosing sepsis or septic shock were 66.67%and 83.87%.When hs-CRP≥20 mg/L was used as the positive criterion,the sensitivity and specificity in diagnosing sepsis or septic shock were71.43%and 80.65%.When using IL-12≥300 ng/L and hs-CRP≥20 mg/L as the combinatorial positive criteria,the sensitivity and specificity in diagnosing sepsis or septic shock were 85.71%and 93.55%.CONCLUSIONSerum IL-12 and hs-CRP levels can be used for early diagnosis of neonatal infectious diseases and determination of occurrence of bacterial infection,and they can be used to accurately determine whether sepsis and septic shock would occur in the children.
引文
[1]岑康群,杨怀,王予川.新生儿败血症流行病学调查[J].中华医院感染学杂志,2013,23(22):5474-5476.
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[4]胡金川,李岩,张立敏,等.超敏C反应蛋白即时检验方法性能评价[J].中国卫生检验杂志,2013,23(10):2259-2261.
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[8]周素芽,王丽娜,周琴,等.血清降钙素原与超敏C-反应蛋白在新生儿感染性疾病中的表达及其临床评价[J].中华医院感染学杂志,2016,26(12):2837-2839.
[9]Martinez-Lopez M,Iborra S,Conde‐Garrosa R,et al.Batf3-dependent CD103+dendritic cells are major producers of IL‐12that drive local Th1immunity against Leishmania major infection in mice[J].Eur J Immunol,2015,45(1):119-129.
[10]Meng H,Lee Y,Ba Z,e t al.Consumption of Bifidobacterium animalis subsp.lactis BB‐12impacts upper respiratory tract infection and the function of NK and T cells in healthy adults[J].Mol Nutr Food Res,2016,60(5):1161-1171.
[11]杨景英,陈学利,吴文钦,等.白细胞介素-12家族与感染性疾病相关研究进展[J].临床检验杂志,2014,32(6):443-446.
[12]Cheng CH,Yang FF,Ling RZ,et al.Effects of ammonia exposure on apoptosis,oxidative stress and immune response in pufferfish(Takifugu obscurus)[J].Aquat Toxicol,2015,164:61-71.
[13]Doumatey A P,Zhou J,Adeyemo A,et al.High-sensitivity C-reactive protein(hs-CRP)remains highly stable in longterm archived human serum[J].Clin Biochem,2014,47(4-5):315-318.
[14]王明霞,徐洪安,刘建平.血清PCT和hs-CRP在新生儿全身炎症反应综合征的应用价值[J].四川医学,2015,36(7):1017-1019.
[15]Srinivasan A,Aggarwal A,Gaudihalli S,et al.Impact of early leucocytosis and elevated hs-CRP on delayed cerebral ischemia and neurological outcome following subarachnoid hemorrhage[J].World Neurosurg,2016,90:91-95.
[16]高春彪.hs-CRP,血常规联合检验应用于小儿细菌性感染性疾病中的诊断价值[J].实验与检验医学,2012,30(6):605-607.
[17]Zabrecky KA,Slovis NM,Constable PD,et al.Plasma C‐reactive protein and haptoglobin concentrations in critically ill neonatal foals[J].J Vet Intern Med,2015,29(2):673-677.
[2]Rawlinson WD,Boppana SB,Fowler KB,et al.Congenital cytomegalovirus infection in pregnancy and the neonate:consensus recommendations for prevention,diagnosis,and therapy[J].Lancet Infect Dis,2017,17(6):e177-e188.
[3]Alipour B,Homayouni-Rad A,Vaghef‐Mehrabany E,et al.Effects of Lactobacillus casei supplementation on disease activity and inflammatory cytokines in rheumatoid arthritis patients:a randomized double‐blind clinical trial[J].Int JRheum Dis,2014,17(5):519-527.
[4]胡金川,李岩,张立敏,等.超敏C反应蛋白即时检验方法性能评价[J].中国卫生检验杂志,2013,23(10):2259-2261.
[5]Shah J,Jefferies A L,Yoon E W,et al.Risk factors and outcomes of late-onset bacterial sepsis in preterm neonates born at<32weeks'gestation[J].Am J Perinatol,2015,32(7):675-682.
[6]熊金月.新生儿脐部感染原因分析及护理进展[J].基层医学论坛,2016,20(17):2400-2402.
[7]Kollmann T R,Kampmann B,Mazmanian S K,et al.Protecting the newborn and young infant from infectious diseases:lessons from immune ontogeny[J].Immunity,2017,46(3):350-363.
[8]周素芽,王丽娜,周琴,等.血清降钙素原与超敏C-反应蛋白在新生儿感染性疾病中的表达及其临床评价[J].中华医院感染学杂志,2016,26(12):2837-2839.
[9]Martinez-Lopez M,Iborra S,Conde‐Garrosa R,et al.Batf3-dependent CD103+dendritic cells are major producers of IL‐12that drive local Th1immunity against Leishmania major infection in mice[J].Eur J Immunol,2015,45(1):119-129.
[10]Meng H,Lee Y,Ba Z,e t al.Consumption of Bifidobacterium animalis subsp.lactis BB‐12impacts upper respiratory tract infection and the function of NK and T cells in healthy adults[J].Mol Nutr Food Res,2016,60(5):1161-1171.
[11]杨景英,陈学利,吴文钦,等.白细胞介素-12家族与感染性疾病相关研究进展[J].临床检验杂志,2014,32(6):443-446.
[12]Cheng CH,Yang FF,Ling RZ,et al.Effects of ammonia exposure on apoptosis,oxidative stress and immune response in pufferfish(Takifugu obscurus)[J].Aquat Toxicol,2015,164:61-71.
[13]Doumatey A P,Zhou J,Adeyemo A,et al.High-sensitivity C-reactive protein(hs-CRP)remains highly stable in longterm archived human serum[J].Clin Biochem,2014,47(4-5):315-318.
[14]王明霞,徐洪安,刘建平.血清PCT和hs-CRP在新生儿全身炎症反应综合征的应用价值[J].四川医学,2015,36(7):1017-1019.
[15]Srinivasan A,Aggarwal A,Gaudihalli S,et al.Impact of early leucocytosis and elevated hs-CRP on delayed cerebral ischemia and neurological outcome following subarachnoid hemorrhage[J].World Neurosurg,2016,90:91-95.
[16]高春彪.hs-CRP,血常规联合检验应用于小儿细菌性感染性疾病中的诊断价值[J].实验与检验医学,2012,30(6):605-607.
[17]Zabrecky KA,Slovis NM,Constable PD,et al.Plasma C‐reactive protein and haptoglobin concentrations in critically ill neonatal foals[J].J Vet Intern Med,2015,29(2):673-677.